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Awaiting moderation 17833 Article |
Hrt: when does the menopause happen? HRT: WHEN DOES THE MENOPAUSE HAPPEN?
‘I heard that the earlier you start your periods the earlier they finish.’
‘Oh, I thought it was just the opposite, that the earlier you started the later you finish.’
When used by doctors, the term 'menopause' means, literally, 'last menstrual period', but women use it to mean that whole period of their lives between first starting to experience menopausal symptoms, such as hot flushes, and the end of their periods and the troublesome symptoms. Doctors use the word 'climacteric' to describe this period (from the Greek klimakier, meaning a critical period'), and they divide it loosely into three phases:
Pre-menopause. When periods are still regular, but the first symptoms may appear - usually hot flushes and mood changes.
Peri-menopause. When the ovaries' function declines, periods become irregular, and symptoms either start or become troublesome. This leads up to the time of the last menstrual period.
Post-menopause From the time of a woman's last period until the end of her days.
The problem with the concept of a 'last menstrual period' is that a woman doesn't know she has had her last period until quite a long time afterwards. Was that last period the last one, or will you get another one in several months' time? It's not until about a year has passed without a period that it is safe to say you have finished. Consequently, the period of time we call the menopause (and doctors call the climacteric) has no clear beginning or end. For some women it will last only a year, for most about two to three years, but about one quarter of all women will still be experiencing 'short-term' menopausal symptoms five or more years after they began.
It isn't known exactly what determines the age at which a woman reaches the menopause. Nutrition is important; poor nutrition brings it on earner. Women who have never borne children tend to have an earlier menopause than women who have had several children, and those whose last pregnancy occurred before their late twenties reputedly have an earlier menopause than those whose last pregnancy was in their thirties. Smokers reach the menopause up to five years earlier than non-smokers, probably because smoking lowers oestrogen levels, and 'passive smokers' (non-smokers who live or work amongst smokers) also tend to have an earlier menopause.
As a rough guide, most women (though by no means all) will experience the menopause at about the same time as their mothers or older female relatives did. But how do you know when that was? It's highly likely that neither your mother nor your elderly aunts ever discussed with you their experiences of the menopause; hopefully, you will feel better able to talk to your daughter about it than your mother did to you.
It is safe to say, however, that at some time in your middle years, things will start to change. It is most likely to happen around the mid to late forties, occasionally in the early fifties, and in some women it can happen as early as their thirties. Although the age at which girls start their periods has got earlier over the last few hundred years, the average age for the menopause still remains at about 50. In the third century BC, Aristode noticed that women couldn't have children after about the age of 50. In the Middle Ages, the age was put at 50-ish, and it is still that today. We can still expect to end our reproductive days at about the same age our pre-Christian forebears did, despite the fact that our expectation of life has more than doubled since then.
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